MAFLD and glomerular hyperfiltration in subjects with prediabetes, visceral obesity and “preserved” kidney function: A cross-sectional study

Parvanova, Aneliya; Abbate, Manuela; Yañez, Aina; Bennasar-Veny, Miquel; López-González, Ángel Arturo; Manent, José Ignacio Ramírez; Iliev, Ilian; Fresneda, Sergio; Arias-Fernández, María; Ruggenenti, Piero

doi:10.1016/j.diabres.2023.110729

Cited by 3 publications

(2 citation statements)

References 45 publications

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“…Conversely to our results, no association was found with hepatic fibrosis, but the different population studied and the low prevalence of fibrosis in the paediatric population (around 8%) may explain this difference. Another recent study conducted on a large cohort of Spanish patients with prediabetes and visceral adiposity showed an independent association between liver steatosis and GH, and the age-mediated GFR reduction appears to be potentiated by MASLD [22]. Finally, a study conducted In an Asiatic population of 147,162 Korean subjects without CKD nor hepatic steatosis and followed up for 4 years showed that the presence of GH at baseline (present in 5% of the cohort) was an independent risk factor for the development of liver fat diagnosed by US (OR 1.21, CI 95% 1.14-1.29) and for its progression to fibrosis assessed by the NAFLD fibrosis score (OR 1.42, CI 95% 1.11-1.82) [23].…”

Section: Discussionmentioning

confidence: 92%

Glomerular Hyperfiltration: A Marker of Fibrosis Severity in Metabolic Associated Steatotic Liver Disease in an Adult Population

Dalbeni,

Garbin,

Zoncapè

et al. 2023

IJMS

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Glomerular hyperfiltration (GH) is an increase in the glomerular filtration rate, possibly progressing to chronic kidney disease (CKD). Metabolic-associated steatotic liver disease (MASLD) is linked to an increased risk of CKD, especially if fibrosis is present; however, the association between GH and MASLD has not been explored. To evaluate GH prevalence in MASLD and its possible correlation with liver fibrosis. 772 consecutive patients with ultrasound MASLD (mean age 47.3 ± 8.9 years, 67.1% males) were enrolled. GH was defined as estimated glomerular filtration rate (eGFR) greater than the upper quartile of values in the cohort. Liver stiffness measurement (LSM) by FibroScan ≥ 7.2 kPa suggested liver fibrosis. GH was present in 20% of patients, liver fibrosis in 30%. In total, 53.4% of the cohort was obese, 40.9% hypertensive, 36.3% diabetic and 70.8% dyslipidaemic. GH patients compared to non-GH were significantly younger (38.4 ± 8.3 vs. 49.5 ± 7.7, p < 0.001), with higher prevalence of LSM > 7.2 kPa (35.5% vs. 29%, p < 0.001), without any difference in metabolic comorbidities. In multivariate analysis, age (OR 0.85, CI 95% 0.82–0.87) and significant fibrosis (OR 1.83; CI 95%1.10–3.03) remained independently associated with GH, regardless of the presence of metabolic alterations and nephrotoxic drugs. GH, an early marker of renal damage, is highly prevalent in MASLD and is associated with hepatic fibrosis. GH may be considered an early marker of both liver and renal disease and its recognition could prompt the management of risk factors aimed at preventing the progression of both hepatic and renal disease.

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Section: Discussionmentioning

confidence: 92%

Glomerular Hyperfiltration: A Marker of Fibrosis Severity in Metabolic Associated Steatotic Liver Disease in an Adult Population

Dalbeni,

Garbin,

Zoncapè

et al. 2023

IJMS

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“…[17][18][19] Moreover, preliminary data show that MAFLD is also associated with glomerular hyperfiltration in subjects with T2DM 20 or prediabetes and visceral obesity. 21 Together, these two abnormalities might synergistically contribute to the pathogenesis of CKD in these populations. On the other hand, finding that MAFLD and glomerular hyperfiltration, in addition to obesity and diabetes, may share a large series of other metabolic and functional abnormalities such as insulin resistance, prediabetes, dyslipidemia, hypertension, and progressively worsening kidney function, strongly suggests that the two abnormalities could be sustained by common pathogenic mechanisms.…”

Section: Introductionmentioning

confidence: 99%

MAFLD and glomerular hyperfiltration in subjects with normoglycemia, prediabetes and type 2 diabetes: A cross‐sectional population study

Abbate,

Parvanova,

López‐González

et al. 2024

Diabetes Metabolism Res

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BackgroundMetabolic dysfunction‐associated fatty liver disease (MAFLD, 2020 diagnostic criteria) and glomerular hyperfiltration share common risk factors, including obesity, insulin resistance, impaired glucose tolerance, diabetes, dyslipidemia, and hypertension.AimsTo assess the prevalence of MAFLD and its association with glomerular hyperfiltration and age‐related worsening of kidney function in subjects with normoglycemia, prediabetes and type 2 diabetes mellitus (T2DM).MethodsWe analysed data recorded during occupational health visits of 125,070 Spanish civil servants aged 18–65 years with a de‐indexed glomerular filtration rate (GFR) estimated with the chronic‐kidney‐disease‐epidemiological (CKD‐EPI) equation (estimated glomerular filtration rate [eGFR]) ≥60 mL/min. Subjects were categorised according to fasting plasma glucose levels <100 mg/dL (normoglycemia), ≥100 and ≤ 125 mg/dL (prediabetes), or ≥126 mg/dL and/or antidiabetic treatment (T2DM). The association between MAFLD and glomerular hyperfiltration, defined as a de‐indexed eGFR above the age‐ and gender‐specific 95th percentile, was assessed by multivariable logistic regression.ResultsIn the whole study group, MAFLD prevalence averaged 19.3%. The prevalence progressively increased from 14.7% to 33.2% and to 48.9% in subjects with normoglycemia, prediabetes and T2DM, respectively (p < 0.001 for trend). Adjusted odds ratio (95% CI) for the association between MAFLD and hyperfiltration was 9.06 (8.53–9.62) in the study group considered as a whole, and 8.60 (8.03–9.21), 9.52 (8.11–11.18) and 8.31 (6.70–10.30) in subjects with normoglycemia, prediabetes and T2DM considered separately. In stratified analyses, MAFLD amplified age‐dependent eGFR decline in all groups (p < 0.001).ConclusionsMAFLD prevalence increases across the glycaemic spectrum. MAFLD is significantly associated with hyperfiltration and amplifies the age‐related eGFR decline.

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Cardiovascular Risk Related to Glomerular Hyperfiltration in Nondiabetic Individuals: Increasing Visibility is Crucial

Valtuille

2023

CHYR

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Abstract:: Glomerular hyperfiltration (GHF), defined by different estimation formulas, has been widely studied as a predictor of proteinuria and progression to chronic kidney disease (CKD) in diabetic patients. GHF is also an important cardiovascular (CV) risk factor and is related to all-cause mortality in non-diabetic populations; however, the upper limit of glomerular filtration rate (GFR) above which it indicates the presence of GHF is weakly defined. This higher risk is as high as in the intermediate stages of CKD and is greater than the presence of diabetes or smok-ing and is still present in non-albuminuria patients. The original Chronic Kidney Disease Epide-miology Collaboration (CKD-EPI) estimation GFR formula showed lower error at higher glo-merular filtration (GF) values, was the most used in population studies, and behaved as a better risk predictor. In our review (including approximately 3.6 million individuals), higher GFR val-ues related to increased mortality risk varied from 106.6 to 113.7 ml/min, which are usually not considered risk values for standard guidelines in non-albuminuric patients. However, the lack of consensus on a GF cutoff value, as well as its variability due to sex and progressive reduction with age, affect the knowledge of this serious phenomenon in clinical practice. Although the el-derly population is not exempted from the effects of GHF, the search for this phenomenon should be intensified in middle-aged populations because of their lower disease burden, where this situation may be more evident, and the possibility of reversing the consequences is greater. A population group often considered healthy includes obese people, essential hypertensives, smokers, and carriers of fatty liver, where the GHF phenomenon is frequent and is associated with CV disease, kidney disease, and higher mortality. Increasing its visibility by the medical community is essential to reduce the effects of GHF, emphasizing more frequent controls and implementing general measures that include strict control of hypertension, Na restriction, rich in vegetables diets and increased physical activity. Initiatives to confirm the beneficial effects of sodium-glucose cotransporter-2 inhibitors to treat isolated GHF would be an important break-through in reducing the severe consequences of this phenomenon.

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MAFLD and glomerular hyperfiltration in subjects with prediabetes, visceral obesity and “preserved” kidney function: A cross-sectional study

Cited by 3 publications

References 45 publications

Glomerular Hyperfiltration: A Marker of Fibrosis Severity in Metabolic Associated Steatotic Liver Disease in an Adult Population

Glomerular Hyperfiltration: A Marker of Fibrosis Severity in Metabolic Associated Steatotic Liver Disease in an Adult Population

MAFLD and glomerular hyperfiltration in subjects with normoglycemia, prediabetes and type 2 diabetes: A cross‐sectional population study

Cardiovascular Risk Related to Glomerular Hyperfiltration in Nondiabetic Individuals: Increasing Visibility is Crucial

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